Cimetidine Caffeine

CYP2D6 22ql3.1 Cytochrome P450, Cytochrome P450, sub- Amitriptyhne, caffeine, cimetidine. Breast neoplasms. Susceptibility to CPD6 CYP2D ... 

A2 Phenacetin, theophylline, acetaminophen, warfarin, caffeine, cimetidine Aromatic amines, arylhydrocarbons, NNK,3 aflatoxin, estradiol Caffeine, [acetanilide, methoxyresorufin, ethoxyresorufin]... 

Wong, S.H.Y. Marzouk, N. McHugh, S.L. Cazes, E. Simultaneous determination of theophylline and caffeine by reversed phase liquid chromatography using phenyl column. J.Liq.Chromatogr., 1985,8, 1797-1816 [also caffeine, cimetidine, codeine, dimethylxanthine, meperidine, pentobarbital, pheno-barbital, secobarbital, theobromine, theophylline hydroxyethyltheophylline is IS]... 

Noninterfering acetaminophen, caffeine, cimetidine sulfoxide, diazepam, digoxin, flura-zepam, furosemide, methyldopa, minoxidil, propranolol, quinidine, sulfinpyrazone Interiering procainamide, tolazamide... 

Noninterfering acetaminophen, caffeine, cimetidine, diazepam, diltiazem, doxepin, flur-azepam, nifedipine, procainamide, quinidine, theophylline, verapamil... 

Simultaneous acetaminophen, amoxicillin, aspirin, caffeine, cimetidine, codeine, diazepam, omeprazole, ranitidine, theophylline Interfering imipramine... 

Drugs that may be affected by mexiletine include cimetidine, caffeine, and theophylline. 

Drugs that may interact with terbinafine include the following Cimetidine, rifampin, terfenadine, caffeine, dextromethorphan, cyclosporine. 

Un, acute exacerbation of chronic bronchitis prophylaxis in transurethral procedures Action Quinolone antibiotic -1- DNA gyrase. Dose 400 mg/d PO X w/ renal insuff, avoid antacids Caution [C, —] Interactions w/ cation-containing products Contra Quinolone all gy, children <18 y,T QT interval, X Disp Tabs SE NA/ /D, abd pain, photosens, Szs, HA, dizziness, tendon rupture, periph al neuropathy, pseudomembranous cohtis, anaphylaxis Interactions t Effects W/ cimetidine, probenecid T effects OF cyclosporine, warfarin, caffeine X effects W/ antacids EMS Monitor ECG for TqT int val, esp in pts taking class lA/III antiarrhythmics monitor ECG and BP for signs of h5 povolemia and electrol5rte disturbances (hypokalemia) d/t D T risk of photosensitivity Rxns OD May cause NA /D, confusion and Szs symptomatic and supportive... 

Substrates Inhibitors Inducers CYP1A2 Acetaminophen, caffeine, clozapine, imipramine, theophylline, propranolol Most fluoroquinolone antibiotics, fluvoxamine, cimetidine Tobacco smoking, charcoal-broiled foods, cruciferous vegetables, omeprazole... 

Omeprazole can inhibit the metabolism of drugs metabolised mainly by the cytochrome P-450 enzyme subfamily 2C (diazepam, phenytoin), but not of those metabolished by subfamilies lA (caffeine, theophylline), 2D (metoprolol, propranolol), and 3A (ciclosporin, lidocaine (lignocaine), quinidine). Since relatively few drugs are metabolised mainly by 2C compared with 2D and 3A, the potential for omeprazole to interfere with the metabolism of other drugs appears to be limited, but the half lives of diazepam and phenytoin are prolonged as much as by cimetidine. 

CNS, smooth muscle T diuresis X- pit aggregation Available forms Daily t doses w/ max 3 g PO daily Contra Avoid in PRG lactation, CAD, hyperthyroidism, anxiety disorders d/t high, caffeine content Notes/SE Insomnia, tach, anxiety, N/V, HA, HTN, Sz Interactions T Effects OF anticoagulants, anti-pits, BBs, bron-choclilators T risk of hypertensive crisis W/ MAOIs T effects W/ cimetidine, ciprofloxacin, ephedrine, hormonal contraceptives, dieophylline, cola, coffee X-effects OF adenosine, antihypertensives, benzodiazepines, Fe, X- effects W/ smoking EMS Tinctures contain EtOH may exacerbate GI disorders HTN T effects of anticoagulants and BBs... 

Caffeine cannot sober a drunk or save someone who is lethargic or unconscious from an overdose of a sedating drug. However, because caffeine lowers stomach pH, it can affect the absorption of other substances. Other drugs such as oral contraceptives, cimetidine, disulfiram, and alcohol can delay the body s ability to rid itself of caffeine. 

Figure 6.17 The classification of 42 drugs in the (solubility-dose ratio, apparent permeability) plane of the QBCS. The intersection of the dashed lines drawn at the cutoff points form the region of the borderline drugs. Key 1 acetyl salicylic acid 2 atenolol 3 caffeine 4 carbamazepine 5 chlorpheniramine 6 chlorothiazide 7 cimetidine 8 clonidine 9 corticosterone 10 desipramine 11 dexamethasone 12 diazepam 13 digoxin 14 diltiazem 15 disopyramide 16 furosemide 17 gancidovir 18 glycine 19 grizeofulvin 20 hydrochlorothiazide 21 hydrocortisone 22 ibuprofen 23 indomethacine 24 ketoprofen 25 mannitol 26 metoprolol 27 naproxen 28 panadiplon 29 phenytoin 30 piroxicam 31 propanolol 32 quinidine 33 ranitidine 34 salicylic acid 35 saquinavir 36 scopolamine 37 sulfasalazine 38 sulpiride 39 testosterone 40 theophylline 41 verapamil HC1 42 zidovudine.

Drug interactions The effect of antacids and cations on the absorption of these agents was considered above. Ciprofloxacin, ofloxacin and enoxacin can increase the serum levels of theophylline by inhibiting its metabolism. They also may raise levels of warfarin, caffeine and cyclosporine. Cimetidine interferes with the... 

A typical example of the characterization of a polymorphic system by FT Raman spectroscopy has been given by Gu and Jiang (1995) while an application of the technique with near infrared excitation to the polymorphic cimetidine system has been described by Tudor et al. (1991). The FT Raman technique has been compared to infrared diffuse reflection spectroscopy in the study of the polymorphs of spironolactone (Neville et al. 1992), and the pseudopolymorphic transition of caffeine hydrate (i.e. loss of solvent) has been monitored using the technique (de Matas et al. 1996). 

Caffeine is rapidly absorbed after an oral dose, with peak levels reached within 1-2 h at therapeutic doses. Onset of clinical effects occurs within 60 min. In adults, caffeine is extensively metabolized by the liver primarily by N-demethylation. It is excreted in the urine primarily as 1-methyluric acid and 1-methylxan-thine. Theophylline (1,3-dimethylxanthine) is a minor product of caffeine metabolism in adults (< 1%). After massive caffeine overdoses, serum levels of theophylline are measurable. The elimination half-life of caffeine is 3-6 h at therapeutic doses. The half-life is shorter in smokers and is prolonged by oral contraceptives, cimetidine, late pregnancy, and in overdose. The half-life of caffeine is much longer in infants and does not approximate that seen in adults until 6 months of age. The half-life of caffeine may exceed 100 h in preterm infants. Only 1-10% of caffeine appears unchanged in the urine in adults. Neonates may excrete up to 85% of caffeine unchanged. 

Imidazole, 1-methylimidazole, L-histidine, ethylenediamine, caffeine and teophylline were purchased from Kanto Chemicals. Cimetidine, famotidine, omeprazole, thioperamide and dansyl-L-phenylalanine (DNS-Phe) were from Sigma. Histamine (Nacalai Tesque), 3-methylhistamine dihydrochloride (Calbiochem), bis(2,4,6-trichlorophenyl)oxalate (TCPO Tokyo Kasei) and hydrogen peroxide (31% H2O2 Mitsubishi Gas Chemicals) were used as received. Triazolam, estazolam, midazolam and alprazolam were generously supplied from pharmaceutical companies. Special... 

Also analyzed acebutolol, acepromazine, acetaminophen, acetazolamide, acetophenazine, albuterol, amitriptyline, amobarbital, amoxapine, antipsrrine, atenolol, atropine, azata-dine, baclofen, benzocaine, bromocriptine, brompheniramine, brotizolam, bupivacaine, buspirone, butabarbital, butalbital, caffeine, carbamazepine, cetirizine, chlorqyclizine, chlordiazepoxide, chlormezanone, chloroquine, chlorpheniramine, chlorpromazine, chlorpropamide, chlorprothixene, chlorthalidone, chlorzoxazone, cimetidine, cisapride, clomipramine, clonazepam, clonidine, clozapine, cocaine, codeine, colchicine, qyclizine, (yclo-benzaprine, dantrolene, desipramine, diazepam, diclofenac, diflunisal, diltiazem, diphenhydramine, diphenidol, dipheno late, dipyridamole, disopyramide, dobutamine, doxapram, doxepin, droperidol, encainide, ethidium bromide, ethopropazine, fenoprofen, fentanyl, flavoxate, fluoxetine, fluphenazine, flurazepam, flurbiprofen, fluvoxamine, fii-rosemide, glutethimide, glyburide, guaifenesin, haloperidol, homatropine, hydralazine, hydrochlorothiazide, hydrocodone, hydromorphone, hydro g chloroquine, hydroxyzine, ibuprofen, imipramine, indomethacin, ketoconazole, ketoprofen, ketorolac, labetalol, le-vorphanol, lidocaine, loratadine, lorazepam, lovastatin, loxapine, mazindol, mefenamic acid, meperidine, mephenytoin, mepivacaine, mesoridazine, metaproterenol, methadone, methdilazine, methocarbamol, methotrexate, methotrimeprazine, methoxamine, methyl-dopa, methylphenidate, metoclopramide, metolazone, metoprolol, metronidazole, midazolam, moclobemide, morphine, nadolol, nalbuphine, naloxone, naphazoline, naproxen, nifedipine, nizatidine, norepinephrine, nortriptyline, oxazepam, oxycodone, oxymetazo-line, paroxetine, pemoline, pentazocine, pentobarbital, pentoxifylline, perphenazine, pheniramine, phenobarbital, phenol, phenolphthalein, phentolamine, phenylbutazone, phenyltoloxamine, phenytoin, pimozide, pindolol, piroxicam, pramoxine, prazepam, prazosin, probenecid, procainamide, procaine, prochlorperazine, procyclidine, promazine, promethazine, propafenone, propantheline, propiomazine, propofol, propranolol, protriptyline, quazepam, quinidine, quinine, racemethorphan, ranitidine, remoxipride, risperidone, salicylic acid, scopolamine, secobarbital, sertraline, sotalol, spironolactone, sulfinpyrazone, sulindac, temazepam, terbutaline, terfenadine, tetracaine, theophylline, thiethyl-perazine, thiopental, thioridazine, thiothixene, timolol, tocainide, tolbutamide, tolmetin, trazodone, triamterene, triazolam, trifluoperazine, triflupromazine, trimeprazine, trimethoprim, trimipramine, verapamil, warfarin, xylometazoline, yohimbine, zopiclone... 

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